We are to report a case of cerebral fat embolism for presenting with unconsciousness without any respiratory dysfunction after intramedullary nailing for femur and tibia fractures. A sixteen-year-old boy was involved in motorcycle accident. His consciousness was alert. He had closed shaft fractures of left femur and left tibia and underwent standard femoral and tibial nail insertions. During the operation, there was no change of vital signs and saturation of oxygen. The consciousness was stuporous after the surgery. The brain CT was normal, but multiple high-signal intensity lesions in T2-weighted and diffusion-weighted images were found at bilateral cerebral hemispheres, corpus callosum, and pons. He woke up on postoperative day 12 and recovered to speak fluently without any neurological deficits at 3 months later. MR image should be recommended if the patient is not neurologically stable after the surgery for lone-bone fractures.
Brain ; Cerebrum ; Consciousness ; Corpus Callosum ; Embolism, Fat* ; Femur* ; Fracture Fixation ; Fracture Fixation, Intramedullary* ; Humans ; Magnetic Resonance Imaging ; Male ; Motorcycles ; Oxygen ; Pons ; Stupor ; Tibia* ; Unconsciousness ; Vital Signs

Temporal fossa hollowing can represent a serious cosmetic concern to patients after post-traumatic surgery, oncological resection, or surgical dissection for obtaining access to the temporal area. Various methods have been described to augment temporal fossa hollowing, such as use of autogenous bone and cartilage implants, high-density polyethylene implants, and dermal fat grafts. We report a case of 22-year-old man with temporal fossa hollowing after post-traumatic surgery, including temporal muscle resection, whose defect was augmented by using titanium mesh even though long after cranioplasty.
Cartilage ; Humans ; Methods ; Polyethylene ; Temporal Muscle* ; Titanium* ; Transplants ; Young Adult

We are to report a case of cerebral fat embolism for presenting with unconsciousness without any respiratory dysfunction after intramedullary nailing for femur and tibia fractures. A sixteen-year-old boy was involved in motorcycle accident. His consciousness was alert. He had closed shaft fractures of left femur and left tibia and underwent standard femoral and tibial nail insertions. During the operation, there was no change of vital signs and saturation of oxygen. The consciousness was stuporous after the surgery. The brain CT was normal, but multiple high-signal intensity lesions in T2-weighted and diffusion-weighted images were found at bilateral cerebral hemispheres, corpus callosum, and pons. He woke up on postoperative day 12 and recovered to speak fluently without any neurological deficits at 3 months later. MR image should be recommended if the patient is not neurologically stable after the surgery for lone-bone fractures.
Brain ; Cerebrum ; Consciousness ; Corpus Callosum ; Embolism, Fat* ; Femur* ; Fracture Fixation ; Fracture Fixation, Intramedullary* ; Humans ; Magnetic Resonance Imaging ; Male ; Motorcycles ; Oxygen ; Pons ; Stupor ; Tibia* ; Unconsciousness ; Vital Signs

Oral anticoagulant therapy is generally being used in patient with a high thromboembolic risk such as cerebrovascular or cardiovascular accident, in spite of increased bleeding tendencies and most of them are old-age patients. A stroke frequently leads to a fall, which in turn causes a minor trauma, and it is often reported that anticoagulant therapy for treatment of stroke may aggravate traumatic brain injury. The authors report a case that required surgical treatments for subacute subdural hematoma which was found during antiplatelets and anticoagulant therapy for acute ischemic stroke. The hematoma had not been found at the time of head injury accompanied by a cerebral infarction.
Brain Injuries ; Cerebral Infarction* ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural* ; Hemorrhage ; Humans ; Stroke ; Warfarin

Temporal fossa hollowing can represent a serious cosmetic concern to patients after post-traumatic surgery, oncological resection, or surgical dissection for obtaining access to the temporal area. Various methods have been described to augment temporal fossa hollowing, such as use of autogenous bone and cartilage implants, high-density polyethylene implants, and dermal fat grafts. We report a case of 22-year-old man with temporal fossa hollowing after post-traumatic surgery, including temporal muscle resection, whose defect was augmented by using titanium mesh even though long after cranioplasty.
Cartilage ; Humans ; Methods ; Polyethylene ; Temporal Muscle* ; Titanium* ; Transplants ; Young Adult

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.
Bronchoscopy ; Dilatation ; Female ; Humans ; Intracranial Hemorrhages ; Intubation, Intratracheal* ; Pneumonia ; Rare Diseases ; Sepsis ; Stroke ; Tracheoesophageal Fistula*

Oral anticoagulant therapy is generally being used in patient with a high thromboembolic risk such as cerebrovascular or cardiovascular accident, in spite of increased bleeding tendencies and most of them are old-age patients. A stroke frequently leads to a fall, which in turn causes a minor trauma, and it is often reported that anticoagulant therapy for treatment of stroke may aggravate traumatic brain injury. The authors report a case that required surgical treatments for subacute subdural hematoma which was found during antiplatelets and anticoagulant therapy for acute ischemic stroke. The hematoma had not been found at the time of head injury accompanied by a cerebral infarction.
Brain Injuries ; Cerebral Infarction* ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural* ; Hemorrhage ; Humans ; Stroke ; Warfarin

Meningitis is the inflammation of the membranes of the brain and spinal cord. This disease is considered life threatening and classified as a medical and emergency. Here we report a case of delayed meningitis occurred in a patient with craniotomy for traumatic brain injury fifteen years ago. Meanwhile, he had been well, however he complained of headache for five days. A brain computed tomographic scan showed air density on the frontal lobe with frontal sinus defect and pansinusitis. His mental state was suddenly changed to stuporous, despite a day of empirical antibiotics. Therefore, a successful cranialization was performed and he was gradually improved. This is a rare case report. Our case shows that surgical intervention is to be considered in some cases of posttraumatic meningitis for effective and rapid control of infection.
Anti-Bacterial Agents ; Brain ; Brain Injuries ; Craniotomy ; Dura Mater* ; Emergencies ; Frontal Lobe ; Frontal Sinus* ; Headache ; Humans ; Inflammation ; Membranes ; Meningitis* ; Spinal Cord ; Stupor

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.
Bronchoscopy ; Dilatation ; Female ; Humans ; Intracranial Hemorrhages ; Intubation, Intratracheal* ; Pneumonia ; Rare Diseases ; Sepsis ; Stroke ; Tracheoesophageal Fistula*

Superficial siderosis (SS) in central nervous system is a rare, slowly progressive disease and usually misdiagnosed or diagnosed too late when the patient is chronically devastated. A 55-year-old man with deafness and gait disturbance for ten years was referred from otorhinologist for evaluation of brain. Magnetic resonance image (MRI) showed symmetric hypointense rim partially delineated the bilateral hemisphere on gradient-recalled-echo T2-weighted image, and it was diagnosed as hemosiderin deposition in subarachnoid and subpial meningeal layer. The correct diagnosis of cerebral superficial siderosis can be achieved by careful neurological examination and MRI because computed tomography findings and symptoms are ambiguous. Serial follow-up of imaging study and education for patient are necessary to prevent progression of SS.
Brain ; Central Nervous System* ; Deafness ; Diagnosis ; Education ; Follow-Up Studies ; Gait ; Hearing Loss, Sensorineural ; Hemosiderin ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Siderosis*